Combined Transversus Thoracic Muscle Plane Block with Pectoral Nerve Block for Pain Relief of Breast Cancer Surgery. A Comparative Controlled Study | ||
| Al-Azhar International Medical Journal | ||
| Volume 2025, Issue 7, July 2025, Pages 53-58 PDF (465.04 K) | ||
| Document Type: Original Article | ||
| DOI: https://doi.org/10.21608/aimj.2025.446636 | ||
| Authors | ||
| Tarek Munir Abo Elanin1; Abdalla Mohammed Abdalla2; Mahmoud Elsayed Rashad Turky* 3 | ||
| 1Professor of Anesthesia, Intensive care and pain management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; | ||
| 2Assistant Professor of Anesthesia, Intensive care and pain management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; | ||
| 3MSc, of Anesthesia and Intensive care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. | ||
| Abstract | ||
| Background: Peripheral artery disease affects millions worldwide. The trans-pedal approach offers a viable alternative for revascularization in complex cases, with specific advantages and technical challenges. Aim: To assess retrograde trans-pedal/tibial access as an alternative for endovascular treatment in critical limb ischemia. This approach is increasingly used for complex infrainguinal occlusions. Patients and methods: this prospective research involved fifty cases of Faculty of Medicine -Al-Azhar University hospital with atherosclerotic occlusive arterial disease. The diagnosis of underlying arterial ischemia in every case will be determined through case history, physical examinations, and the utilization of color Doppler ultrasonography or computed tomography angiography. Results: At 1-month follow-up, primary patency and limb salvage rates were 100% by duplex scan. At 6 months, primary patency was 90% (conservative treatment), with 100% limb salvage and no re-angioplasty needed. Complications included a 34% failure rate (68% [11/17] due to calcified access failure [7 PTA, 3 ATA, 1 PA]; 32% [6/17] due to lesion crossing failure [5 cases] or tibioperoneal trunk wiring [1 case]), 2 conservatively treated hematomas, 1 conservatively treated infection, and 1 peroneal artery perforation (balloon-controlled). Amputation occurred in 16% (8 above-knee cases): 3 due to access failure (2 prior antegrade, 1 retrograde transpedal) and 5 due to lesion crossing failure (4 prior antegrade, 1 retrograde transpedal). | ||
| Keywords | ||
| Breast cancer; TTMP; Pectoral Nerve Block | ||
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